Cholera outbreak continues in South Sudan

In March, a cholera outbreak was reported in South Sudan, with cases in Bentiu (which hosts an internally displaced persons (IDP) camp) followed by Rubkona Town, both in Rubkona County, Unity State (1,2). Overall, a total of 314 cholera cases and one death have been reported (until August 7, 2022). The majority of cases were reported in May (30.3%, 95 cases) and June (34.4%, 108 cases) (3). Most cases (88.9%) have been reported from the Bentiu IDP camp, while 35 (11.1%) originated from three locations outside of the camp: Rubkona town (28 cases), Bentiu town (6 cases) and Roriak (1 case). Females account for 60.8% of the reported cases, and children between the ages of 0 and 4 years are the most-affected age group (35.7% of cases) (3).

During week 31 (ending August 7, 2022), nine new cholera cases were reported, of which eight cases were from the Bentiu IDP camp and one was from Rubkona Town. The observed reduction in cases from week 25 to week 31 should however be interpreted with caution as most reporting sites did not report during these weeks (3).

A recent UNICEF study assessing the dynamics of cholera in South Sudan has found that cholera foci were located in major cities that host large IDP camps and settlements, along the border with Uganda and Kenya, and in the Sudd Swamp along the Nile River. During the epidemic in 2016-2017, cholera outbreaks heavily affected displaced and host communities living in the Sudd Swamp and communities in cattle camps. Indeed, Rubkona County was identified as a cholera hotspot characterized by outbreaks of extended duration (4).

To stop the ongoing outbreak and prevent cholera diffusion to other at-risk counties, gaps in surveillance; case management; community engagement; and water, sanitation and hygiene (WASH) should be urgently addressed (2).